Estudio epidemiológico sobre la prevalencia de uso de medicinas alternativas y complementarias por la población general y un grupo de médicos y estudiantes de medicina de la Comunidad de Madrid

Résumé

Introduction. Complementary and Alternative Medicine (CAM) have an increasing use in Western countries over the past 20 years with use in general population between 30 and 90%. In Spain there are no population studies on the use of these therapies by the general population, although some studies on patients and other indirect factors indicate it could be high. Objectives. To estimate the prevalence of CAM use and alternative products for the general population and a group of staff physicians, medical residents and medical students of the Community of Madrid, and know their demographic characteristics, health problems and reasons for the use, the estimated cost per patient and their views on CAM. Material and methods. Cross-sectional study of prevalence using self-administered survey to four significant random samples: general population belonging to eleven primary care areas of Madrid (n=897), staff physicians (n=324) and residents (n=111) from two hospitals and primary care areas, and students from two schools and university hospitals (n = 45). Results. 288 questionnaires were received from the general population (response rate 14.4%), 165 from staff physicians (51%), 96 from residents (86.5%) and 45 from students (100%). 66% of the general population had used alternative products and 56.3% had used CAM therapies mainly relaxation and massage, for musculoskeletal problems and mental health. Over 75% had higher perception of improvement and satisfaction. The main reason to visit CAM was seeking improvement that was not achieved with conventional medicine. The recommendation of relatives or friends was the main source to know therapies, and more than half had spent less than 50 euros a month in therapies and products. Over 80% felt that CAM should be included in the public health system and health professionals trained in them. In multivariate analysis being a woman, belonging to Area 5 of Primary Care and and having visited more than 9 times health professionals in the past year were the independent factors associated with the use of CAM. 42.1% of non-CAM users had consumed alternative products and 83.5% would turn to CAM if necessary. About doctors and students, they had used alternative products between 25% and 45%, and visited to CAM between 16% and 36% for the same pathologies and the same therapies than the general population, and their perception of improvement and satisfaction was high but to a lesser degree than the general population. The monthly expenditure on CAM and the source to know therapies were the same as the general population. Between 48% and 85% felt that CAM should be included in the public health system and health professionals should be trained in them. Among non-CAM users, 40% and 73% had consumed alternative products and 68% to 76% said they would turn to CAM if needed. When comparing the four subpopulations, the general population had visited CAM from 2 to 4 times more than the rest, and more therapies, and alternative products were consumed from 2 to 3 times more. Conclusions. CAM and alternative products use in the general population is broad, and higher than among physicians and medical students. In all cases the level of satisfaction with CAM is great and a high percentage considered appropriate to include them within the public health system and training of health professionals. Further studies would be needed in general population to confirm these results.